2006 Priorities Hill Briefing a Success

Yesterday, I was joined on Capitol Hill by Toni Fatone, Executive Director of the Connecticut Association of Health Care Facilities, and Fran Kirley, President and CEO of Nexion Health which operates 40 facilities in Louisiana, Texas and Colorado, to deliver our 2006 priority messages. The standing room only crowd included reporters and important Hill staffers. We discussed the importance of preventing the President's proposed FY 2007 Medicare and Medicaid cuts from being enacted, the difficulties our profession faces in obtaining a stable workforce, the potential impact changes to asset transfer policies will have on our facilities and we took the opportunity to re-emphasize our commitment to improving information technology. Toni specifically addressed the impact that the proposal to reduce quality fees – also known as provider taxes – from 6% to 3% would have for patients and facilities in Connecticut, as well as for the other 31 jurisdictions that would encounter Medicaid cuts if the policy was to be enacted. Fran spoke to the impact severe Medicaid and Medicare cuts could have on skilled nursing facilities still reeling from the ravages of Hurricane Katrina. The briefing has already garnered significant media coverage and it served to educate Hill staff.

To read our press release, click here.  

Quality in Motion

Congratulations to the Alliance for a successful meeting - and for shining a light on the issue of quality in long term care.  gathering under the theme of “Positive Momentum” the Alliance For Quality Nursing Home Care (Alliance) convened a conference to showcase its progress in quality improvement efforts and in addressing the goals of the Quality First Initiative.  The one-day conference provided an opportunity for attendees to refocus on Quality First and to discuss how to achieve quality improvement successes.  CMS sent a strong contingent of staffers led by speakers Herb Kuhn, Director, CMS’s Center for Medicare Management, and Paul McGann, MD, Medical Director of CMS’ Office of Clinical Standards & Quality.  Both speakers highlighted the commitment of CMS to quality measurements and support for the Quality First Initiative.   Themes woven throughout the session focused on quality and quality improvement, efficiency and effectiveness, safety, predictability in payment systems, efforts to link payment with quality measures and the need to adopt a person-centered approach that puts “people – all customers – first,” in the words of Keith Weikel, Chair of the Alliance.

Reminder: Part D Transition Ends March 31

March 31, 2006 marks the end of the Medicare Part D 90-day transition period. CMS is reminding Medicare beneficiaries enrolled in Part D to check that all their medications are covered by their Part D Plan (PDP); to talk to their pharmacist about which drugs covered by the PDP could be used instead; and/or consult their doctor to either change to a prescription covered by their plan or to submit an exception/appeal for a non-formulary drug.

CMS Moves Up Facilitated Part D Enrollment

A month earlier than originally scheduled, CMS is mailing letters to 1.2 million Medicare beneficiaries in other federal assistance programs such as Supplemental Security Income (SSI) and Medicare Savings Programs, as well as beneficiaries who have applied and been approved for extra financial help. The letters, which will be printed on green paper to be more easily identified, will explain the Medicare Part D benefit and that the letter’s recipient will be enrolled in a Medicare prescription drug plan (PDP) by CMS if he/she takes no action to enroll or to decline enrollment in Part D before April 30, 2006. Like the auto-enrollment for dual eligible beneficiaries last fall, CMS is enrolling this group of beneficiaries to assure that they receive this benefit immediately, and without having to pay a penalty for enrolling after May 15, 2006.

CMS also is reminding beneficiaries — especially those with “creditable” or existing drug coverage typically from employers or unions — to consider whether or not Part D coverage is as good as, or better than, their existing coverage. In addition, people who lose their creditable coverage can sign up for Part D without paying the premium penalty after May 15, 2006 as long as they enroll in Part D within 63 days of losing creditable coverage. For details or copies of CMS’ facilitated enrollment letters, click here.

Technical Advisory Panel Meeting

NCAL Executive Director David Kyllo recently participated as a member of a technical advisory panel meeting organized by Research Triangle Institute International.  Discussed was the survey design and scope for a federal study of residential care facilities that will focus heavily on assisted living residences and similar settings that care for the elderly.  Three HHS agencies are working together to conduct the federal government's first thorough examination of the residential care market. 

The meeting of the technical panel is the first significant step forward since the three agencies told NCAL about their plans for a national study more than a year ago.  The objectives of the unprecedented research initiative are to:

• Estimate the number of residential care places and the number of residents
• Determine characteristics of residential care places such as geographic location, size, services offered, admission criteria, etc.    
• Determine the characteristics of people living in residential care settings, such as demographics, functional disability

Preliminary research plans are to survey small to very large residential care facilities that  have the primary mission of caring for the elderly.  The study will not focus on facilities that primarily care for the MR/DD population or people with mental illnesses.  Nursing homes are also excluded from the study.

According to government officials, the next year will be spent developing a survey instrument and obtaining funding approval.  Tentative plans indicate that researchers will go out to the field in 2008 and a final report is likely to be published in 2009.  NCAL will keep members apprised of additional developments related to the study. 

Management and Leadership Publications Available

AHCA/NCAL is proud to offer several new publications on management and leadership for long term care professionals. These publications are written with a health care focus and contain information that will assist managers in overcoming challenges found in LTC environments.

• Managing Long-Term Care (Product #6859)
• Becoming An Effective Health Care Manager (Product #6860)
• Handbook For Improvement: A Reference Guide for Tools & Concepts (Product #6864)

Complete product descriptions and price information for these titles can be found online.  For personal assistance in ordering, call 800-321-0343.

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